Lack of Nortriptyline and Red Tape Relapses, Courtesy of Anthem Blue Cross

I don’t think, prior to this past 5 day fiesta, I realized just how powerful and important nortriptyline is in my life.

I take nortriptyline for its ability to block neuropathic pain. Without it, I hurt all over. Well, not ALL over, but my legs hurt like holy hell, especially near the hip joints and knees and my forearms and my back hurt too. It’s kind of a seething, constant pain that sucks my will to live because it hurts so bad it overtakes my conscious thoughts. It stops me from moving, and it stops me from restful sleep. Without restful sleep, I have *tons* more seizures – the epileptic kind, not the kind that we’re able to affect and get rid of thanks to EMDR.

Fortunately, 20 mg of nortriptyline a night takes care of it. It also happens to be a tricyclic antidepressant, which gives me the added benefit of helping me cope with, well, all of the fun and frolic that is life with MS, seizure disorder, and now PTSD. (I think I forgot to write about that in the blog. I’ve been meaning to write a good entry about EMDR and PTSD and about how some of my seizures are actually flashbacks due to repressed memories of abuse…)

Anyway, I ran out of my nortriptyline prescription on Friday of last week, and we called it in to the pharmacy. They said they would contact the doctor. Standard, right? It would be, if Pasadena Rehabilitation Center had refilled the medication. But the doctor wouldn’t refill it because we haven’t been in for a visit this month. Not at all standard for us. Sudden withdrawal symptoms for this medication include headache, nausea, and weakness. That is, of course, unless you’re a Rae. Then it also includes “zomg-so-much-fucking-pain!!!”, sleepless nights, and lots of seizures.

This begs 2 questions in my mind. 1.) Why wouldn’t Anthem Blue Cross allow me to go back to Pasadena Rehabilitation Center for my monthly visit? I already have a $178 bill sitting at home where Anthem just didn’t pay for the visit because they said they didn’t approve that visit. 2.) Why wouldn’t Pasadena Rehabilitation Center refill my nortriptyline?

Fast forward to TUESDAY because on Monday, no one would return my calls, not even my primary care physician. Adam, my husband-turned-champion calls all the doctors. By Tuesday, I was in so much pain I couldn’t even think straight. He came to find out that it all comes down to money and protecting people. Pasadena Rehabilitation Center has a policy of only prescribing enough pills for one month because for many of their patients they have to give them opiates for their pain. But there’s no street value for nortriptyline. Thus, there’s no reason for them denying me my medication aside from the fact that they want more money from us.

So the only question left is why wouldn’t Anthem Blue Cross allow me to go back to my Pain Management Specialist. And I think that one’s pretty obvious. Anthem’s in the business of denying benefits and accepting premiums.

This means that while I give them $788 every two months for my care (And yes, you are remembering right that the government only provides me with $758 every month, thirty dollars LESS than that for those of you who are slow with mental math, they denied me access to my pain management specialist, and thus my pain medication, causing immense pain, seizures, nausea, sleeplessness, headaches (a really intense one that caused me to miss a good party to boot!), weakness, and an inability to go do things, for no reason other than that they wanted to make more money. My premium, which is more than half of the money I have to live off per month is not enough.

I still don’t receive Medicare benefits until March.

So how am I able to feel well enough to type today? Adam called the on-call doctor for Pasadena Rehab after-hours (That brilliant man of mine!), explained this whole situation, and that doctor, understanding the situation in its fullness, took pity on me and gave me 1 week’s worth of it, enough time to get the situation sorted.

Thankfully, we’ve gotten my psychiatrist, Dr. El, to agree to prescribe the nortriptyline from now on. Now to find someone to prescribe the baclofen. Maybe Dr. G., my MS neurologist, will feel comfortable with that one.

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